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A New Path to Hearing with Cochlear Implants

Dr. Brian D. Nicholas, Otolaryngology, Head & Neck Surgery

September 9, 2022

A New Path to Hearing with Cochlear Implants

When 11-year-old Faith Johnson and her parents, Corinne and Matthew, walked into White Plains Hospital on an early morning in March for Faith’s cochlear implant surgery, it seemed that everyone, starting with the security guards, knew who they were and where they were going.

That’s because Faith’s procedure was a milestone, marking the first time a cochlear implant (CI) surgery was
performed at the Hospital, the first of many that Dr. Brian Nicholas, White Plains Hospital’s Director of Hearing and Balance, expects to perform at the Hospital’s new Center for Advanced Medicine & Surgery.

“The indications for cochlear implantation are widening almost every year,” says Dr. Nicholas of the procedure, which offers a life-changing option for patients with hearing loss when hearing aids are
no longer beneficial.

Faith Johnson
Faith Johnson

This is part of what makes the Hospital’s new offering of CI so exciting, he says. “Patients who wouldn’t have been considered candidates five years ago definitely are now because the candidacy has broadened.” Ideal candidates, he explains, include post-lingually deafened people and pre-lingually deafened children, as young as eight months, receiving immeasurable benefits from having a cochlear implant.

A Long Journey

For Faith, the journey to White Plains Hospital was a long time coming. Though she had passed all her hearing tests early on, her doctors began to notice a decline when she was about 3 years old. She started using hearing aids, which proved to be incredibly helpful for the then-toddler.

“Her first set of hearing aids was really amazing,” says Corinne. “She got them put in, and she started tapping her toes; that’s how we realized how much she really couldn’t hear before.”

Since Faith used the hearing aids from such a young age, she was largely able to develop speech and
language normally, says Nicholas, who is board-certified in both otolaryngology (ENT) and otology/neurotology, an ENT subspecialty. He first started caring for Faith at his former practice, in Syracuse, about 25 minutes from the Johnsons’ home in upstate New York.

Faith continued to have her hearing tested at regular intervals, as is common for children with hearing loss, and the testing revealed a continued decline in her hearing. “In Faith’s case, her hearing loss was progressive,” Dr. Nicholas explains.

Testing also revealed that she had difficulty with a specific aspect of hearing. As part of their battery of tests, audiologists establish a person’s threshold for hearing (the decibel level at which they can hear words) and then turn the volume up to a higher decibel level to determine how clearly the person is able to hear those same words.

Hearing the words clearly proved to be an issue for Faith, who when tested was getting less than 20% correct, says Dr. Nicholas. “And that’s just not compatible with everyday communication,” he says. Hearing aids, he adds, do a great job of making sounds louder but not clearer.

While the hearing aids worked well for Faith for much of her young life, by the time she was about 9 years old, she had really exhausted everything the devices could do for her. But Dr. Nicholas thought a cochlear implant could make a big difference.

Considering a Different Option

“A cochlear implant is a device that converts sound to an electrical signal to stimulate the nerve of hearing directly,” he explains. “It is meant to take the place of a damaged cochlea, which normally functions to convert sound (mechanical energy) to electrical energy.”

The CI includes an internal component, which is surgically placed in the ear, plus an external component. The implantation procedure may be done in both ears simultaneously, in just one ear, or sequentially. A common
misconception is that cochlear implantation can be done instead of using hearing aids, but in fact they’re ideal for people, like Faith, for whom hearing aids are no longer helpful. For this reason, as well as the fact
that Faith was post-lingually deafened, Dr. Nicholas felt she would be a good candidate for a CI.

Faith herself, who was nearing 10 by this time, was initially hesitant about the procedure. But it was becoming evident to Corinne and Matthew that it could be a game-changer. Though Faith was learning sign language and was a lip reader, it was getting harder for her to communicate. As people began wearing masks during
the pandemic, lip reading became nearly impossible anywhere except at home, which her mom says further isolated Faith. Her parents also hoped the CI would preserve Faith’s passion for singing, listening to music,
and writing songs. The family ultimately decided to move forward with the cochlear implant in Faith’s right ear, the side where her hearing was worse. That surgery took place successfully in Syracuse on July 28, 2021.

Post-surgery, patients can sometimes lose whatever residual hearing they had on the side in which the implant is placed, explains Dr. Nicholas. But after about three or four weeks, they receive the processor, the external component of the CI, and start hearing from the implant. “The performance with the implant typically improves significantly in the first few weeks of using it,” he says. “We expect the clarity of words to be much better than it was prior to surgery with the use of hearing aids.”

Faith excelled with her CI. “When she returned to school in September, she was an absolutely different child,” says Corinne, explaining that Faith, who is in a mainstream class in public school, had been struggling with her grades; post-surgery, the majority of her grades have been A’s and B’s.

A Trusted Expert

Faith did so well, in fact, that the family began discussing a cochlear implant for her left side as well. In the interim, Dr. Nicholas accepted his new position at White Plains Hospital, but Faith knew she didn’t want any other physician to do the surgery. “She’s got a very tight trust group, and he was in that circle,” says Corinne.

The Johnsons were so committed to Dr. Nicholas that they decided to have the surgery at White Plains Hospital, three and a half hours from their home upstate. Again, it was a success.

“The day could not have gone any smoother,” says Dr. Nicholas.

He now hopes to continue to reach the growing number of patients for whom a cochlear implant would be beneficial.

“[Westchester and the surrounding area] are actually quite underserved with otologists and neurotologists, and in particular, cochlear implants,” he says. “We view this as an opportunity to build this Center, build a comprehensive program, and to offer this life-changing surgery to kids and adults in the region.”

Dr. Brian D. Nicholas

Dr. Brian D. Nicholas is the Director of Hearing and Balance at White Plains Hospital, and sees patients at 122 Maple Ave. in White Plains and at 21 Laurel Ave., Suite 290, in Cornwall. To make an appointment, call 914-849-3755.


Similar Topics: cochlear implant, hearing loss,